This is my first post. I had PRK on 9/6/2007. I thought that the starbursts were a normal part of the healing process. Whenever it is dark out, the car headlights starbursting is extremely annoying. I asked my doctor about it in early December of 2007, and he said that I am at 20/20 in both eyes which is good. But I told him that I was concerned about the starbursts at night. He acted like that was normal for PRK. That was a week ago. I am deeply depressed. I don't know if I can live with these starbursts the rest of my life. I am going to call him back to see if the starbursting ever goes away. I guess the statement that he said, "The good news is that this is the best that it is going to ever get, and the bad news is that this is the best that it ever gets." That statement shocked me. I am about 3 months out on this PRK.

1-Will the starbursts with car headlights ever go away?
2-I know this is extreme, but is it possible to get a cornea transplant?
3-How risky is a cornea transplant?
4-What recourse do I have?
5-Can PRK be reversed?

I feel that the doctor and his staff totally downplayed the risks of PRK. I am starting to feel that the entire field of Lasik/PRK is one the greatest legal scams to ever cross the world. Is it all about the money? Yeah...it probably is. I am sorry that I feel that way. I guess this is all a matter of perspective. If I were blind, and I had my current vision. I would be thrilled. I am glad that this life is not all that there is. Someday, I will meet my God, and the PRK problem will no longer be a problem. I am not recommending that anyone get PRK or LASIK.

I don't think that a cornea transplant would be the right recourse at this time for you - it is high risk and usually done for mechanically or seriously comprimised corenears.

Do you know the reason for the starbursts? There are a few things that could be causing this:

- Dry eye (light scatter)
- Residual refraction (do you have a refractive perscription from your doctor)
- Healing process (are there any issues identified by your doctor?)
- Pupil size and correction zone (this is important to find out from your doctor - ideally your correction zone was larger that your nighttime pupil size, if not starbursts are a risk factor)

If it ends up that you there is a mistmatch there are other avenues to go down. First, time may correct this. You should also get another well qualifed second opinion of what is going on from another doctor. You can also look at RGP (rigid gas permeable contacts) to correct optical problems post RS. I think this recent post of this forum may help you understand your option with contact lenses (http://tinyurl.com/2tcm66). The website laser my eye was banned for whatever reason from the post so I created a tinyurl.

Good luck. I am not an expert in the field, but have read enough during my healing process to hopefully help point you in the right direction. Hopefully others will join in to help.

During PRK the pliable outermost layer of corneal cells - the epithelium - is removed. Although these are the fastest reproducing cells in the human body, they take time to regenerate, thicken, and smooth.

If starbursting is due to corneal edema:

Inflammation of the cornea is very common after PRK. What with the epithelium removed and the cornea lasered, your eyes can be pretty angry and swelling is the common response - even three months later. Edema will induce myopia (nearsighted, shortsighted) vision. Even a small amount of residual myopia can cause or exacerbate starbursts.

If starbursting is due to edge myopia:

If you have unusually large pupils and the treatment area was smaller than the size of your pupils, it is possible that the outer edge of your corneas have residual myopia. When you pupils enlarge in low light environments, the light passing through the myopic portion of your cornea mixes with the light from the fully corrected center of the cornea and this can cause halos around light sources. Read Lasik Starburst.

BillyIdol wrote:2-I know this is extreme, but is it possible to get a cornea transplant?

No legitimate surgeon would provide it. Not for nighttime starbursting.

BillyIdol wrote:4-What recourse do I have?

Ask your doctor if Alphagan P would be appropriate. Alphagan P is a glaucoma medicine that has a side effect of causing the pupils to constrict. It is relatively benign and one drop in the evening can make a world of difference.

Discuss if enhancement surgery would be appropriate. Unless there is something else happening, don't do surgery until you are at least six months postop. You can still experience improvement.

Try contact lenses. They not only can correct residual myopia, but can reshape the cornea to resolve at least some edge myopia.

BillyIdol wrote:5-Can PRK be reversed?

The tissue removed during surgery does not return, however what you really want is to resolve the complication, not reverse the procedure.

BillyIdol wrote:I feel that the doctor and his staff totally downplayed the risks of PRK. I am starting to feel that the entire field of Lasik/PRK is one the greatest legal scams to ever cross the world. Is it all about the money?

It's perfectly natural to be angry when something like this happens. Angry at your doctor, angry at the industry, and angry at yourself. You can beat yourself up for deciding to have an elective - arguably cosmetic - surgery, but that is not going to do you or your eyes any good.

You and your family need to take your emotional response seriously. It is very common to suffer depression after complications from an elective surgery. Seek help from your family, clergy, and physicians. Depression is just as real, an quite possibly more damaging, than the starbursts.

BillyIdol wrote:I guess this is all a matter of perspective.

It really is, but it is also hard to keep perspective when you are suffering these kinds of problems.

Many people who had starbursts have them resolve late in the healing period. Using Alphagan P can get you through while your eyes heal as much as they are able. Then in a few months you can revisit your options and decide what is best.